文章摘要
李茸,雷叡,刘璇,等.正念减压疗法减轻同步放化疗肿瘤病人的心理痛苦[J].安徽医药,2023,27(7):1426-1432.
正念减压疗法减轻同步放化疗肿瘤病人的心理痛苦
Effect of mindfulness-based decompression therapy in alleviating psychological pain of malignant tumor patients undergoing concurrent chemoradiotherapy
  
DOI:10.3969/j.issn.1009-6469.2023.07.034
中文关键词: 正念减压  放化疗病人  心理痛苦  人文关怀
英文关键词: Mindfulness decompression  Patients with radiotherapy and chemotherapy  Psychological pain  Humanistic care
基金项目:陕西省自然科学基础研究计划( 2022JM-597);陕西省重点研发计划( 2022SF-562)
作者单位E-mail
李茸 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
雷叡 陕西省第四人民医院重症医学科陕西西安 710061  
刘璇 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
朱丽 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
王玲 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
邢舒 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
王皎 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
刘东阳 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
李潇 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
李珊珊 西安交通大学第一附属医院肿瘤放疗科陕西 西安 710061  
马卫平 安康市中心医院消化内科内镜中心陕西安康 725000 106616425@qq.com 
姚晚侠 深圳市萨米医疗中心健康管理部广东深圳 518118 yaowanxia@ssmc-sz.com 
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中文摘要:
      目的探讨正念减压疗法在减轻同步放化疗恶性肿瘤病人心理痛苦时的作用。方法选取 2020年 1月至 2021年 6月西安交通大学第一附属医院收治的 120例恶性肿瘤病人,分为观察组和对照组,每组各 60例。对照组病人行常规护理,观察组病人在常规护理的基础上辅以为期 8周的正念减压疗法。观察并对比两组病人心理状态、心理痛苦方面以及生活质量的状况。结果心理痛苦方面:心理痛苦评分,干预前、后痛苦评分[观察组:(5.49±1.88)分、(4.11±1.62)分;对照组:(5.36±1.78)分、(4.71±1.24)分]观察组下降得更为明显( P<0.05)。痛苦程度占比,两组均以中度痛苦为主,两组干预后痛苦程度均趋轻变化,但仅观察组前后差,异有统计学意义( P<0.05);焦虑和抑郁评分:组内比较,干预前、后焦虑和抑郁评分,干预后均比干预前有明显下降,干预后观察组下降得更为明显( P<0.05)。心理健康方面,观察组和对照组在活力( VT)、情感职能( RE)、社会功能;(SF)和精神健康( MH)各维度得分[ VT:(79.51±16.42)分、(71.84±20.82)分; RE:(84.72±19.87)分、(77.29±18.51)分; SF:(85.19±20.15)分、(77.24±19.39)分; MH:(87.44±17.94)分、(80.88±17.57)分],观察组在各维度得分均低于对照组,差异有统计学意义( P<0.05)。到 8周结束正念减压干预时,观察组病人的 CD3+CD4+CD8+NK细胞和白细胞介素 -6表达水平显著增高,皮质醇的表达水平显著下降,差异有统计学意义(P<0.05)。两组各指标、比较、亦均差、异有统计学意义( P<0.05)。结论正念减压疗法能够显著减轻同步放化疗恶性肿瘤病人的心理痛苦,改善病人的焦虑和抑郁状态,提升生活质量。
英文摘要:
      Objective To explore the effect of mindfulness-based decompression therapy (MBSR) on alleviating the psychologicalpain of malignant tumor patients undergoing concurrent chemoradiotherapy.Methods A total of 120 malignant tumor patients admitted to The First Affiliated Hospital of Xi′an Jiaotong University from January 2020 to June 2021 were selected and divided into anobservation group and a control group, with 60 patients in each group. The control group received routine nursing, and the observationgroup received MBSR for 8 weeks on the basis of routine nursing. The psychological distress score, psychological state and quality oflife were observed and compared between the two groups.Results Psychological pain scores: observation group: (5.49±1.88)points,(4.11±1.62)points; control group: (5.36±1.78)points, (4.71±1.24)points, the observation group decreased more obviously after intervention (P < 0.05). The pain degree in both groups was moderate, and the pain degree in both groups eases slightly after intervention, butthere was significant difference between the observation group and the observation group (P < 0.05). Scores of anxiety and depression:Compared with before intervention, both groups were significantly lower after intervention, with statistical significance (P < 0.05), thedecrease was more obvious in the observation group after intervention, there was significant difference between the two groups (P < 0.05); Quality of life score: Scores of physical health [VT: (79.51±16.42)points, (71.84±20.82)points; RE:(84.72±19.87)points, (77.29±18.51)points; SF:(85.19±20.15)points, (77.24±19.39)points; MH:(87.44±17.94)points, (80.88±17.57)points], the dimensions of physicalfunction (PF), physical function (RP) and overall self-assessment of health (GH) were slightly improved in the two groups, while thedimensions of body pain (BP) were decreased, but the differences were not statistically significant. In terms of mental health, the scoresof vitality (VT), social function (SF), emotional function (RE) and mental health (MH) in the observation group were lower than those inthe control group, and the differences were statistically significant (P < 0.05). At the end of 8 weeks after MBSR intervention, the expression levels of CD3+, CD4+, CD8+, NK cells and interleukin-6 in observation group were significantly increased, while the expression level of cortisol was significantly decreased (P < 0.05). The comparison of indexes between the two groups was also significant (P < 0.05).Conclusion Mindfulness decompression can significantly relieve the psychological pain, improve the anxiety and depression,and improve the quality of life of malignant tumor patients with concurrent chemoradiotherapy.
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